Gestational diabetes is a condition pregnancy can induce in women which causes high blood sugar. This high blood sugar can contribute to potential health issues for both the mother and the baby. According to the Centers for Disease Control, diabetes affects between two and ten percent of pregnancies in the United States per year.
How is Gestational Diabetes Diagnosed?
Gestational diabetes typically does not cause any symptoms in the mother. This is why it is so important for early and consistent health care during pregnancy.
A screening test for gestational diabetes called a glucose challenge test, is given between the 24th and 28th week of pregnancy.
A positive test result for the glucose challenge test does not indicate a definitive gestational diabetes diagnosis.
It does indicate a need for a more thorough test called a glucose tolerance test. This test is similar to the original challenge but blood is taken at regular intervals over a longer period of time.
What is Gestational Diabetes?
The cause of gestational diabetes is unknown, but there are some risk factors researchers have identified.
These risk factors include advanced maternal age, a family history of diabetes, being significantly overweight, and for unknown reasons being non-caucasian.
According to the International Diabetes Federation, high blood sugars in pregnant women are most prevalent as women age and especially in women over the age of 45.
Women who may have been diagnosed as being a prediabetic prior to becoming pregnant may be diagnosed with gestational diabetes.
This video produced by the American Diabetes Association, explains what gestational diabetes is.
Pregnancy affects the body in many ways, one of which is producing higher than normal levels of certain hormones.
These hormones interact with insulin in such a way as to prevent it from removing sugar from the blood and moving it into the cells.
The placenta is responsible for producing these counteracting hormones and as the pregnancy progresses, it produces higher levels.
If insulin is affected enough, higher than normal amounts of sugar remain in the blood.
This sugar can affect the growth and health of the fetus. The diabetic condition during pregnancy typically occurs during the second half of pregnancy, or after the 20th week.
What are the Complications of Gestational Diabetes?
Most cases of gestational diabetes can be controlled through diet changes and exercise.
The March of Dimes notes that if it is left unmanaged, it can contribute to complications such as macrosomia (a baby weighing more than nine pounds), preterm birth, low blood sugar in the baby after birth, and an increased rate of C-section.
Untreated gestational diabetes can also contribute to preeclampsia and a higher risk of developing diabetes in the future.
High birth weight babies can lead to many complications during labor and delivery.
Higher Caesarean section rates are noted for women with poorly controlled diabetes because larger babies tend to get stuck in the birth canal.
This can occur with larger babies when their shoulders wedge behind the pelvic bone, necessitating an emergency c-section.
If a larger than normal birth weight is suspected to occur, doctors may need to perform an early C section in order to safely deliver the baby.
This can lead to respiratory distress because although the baby may be large enough, their lungs can be underdeveloped due to being premature.
When babies are constantly exposed to higher than normal sugar during their gestation, when they are removed from this high sugar environment after birth, their blood sugar levels can plunge.
This is known as hypoglycemia and can result in seizures, coma, and even death for infants.
In order to prevent complications of gestational diabetes, changes in the diet while pregnant need to be made along with adding low impact exercise to a routine.
Monitoring the mother’s blood sugar at specific times during the day, like before or after meals, or upon waking will help to determine if medication needs to be used to manage the condition.
How is Gestational Diabetes Managed?
Diet is the most important factor when managing gestational diabetes. When gestational diabetes is well controlled, the risk of complications is reduced.
It is important to be aware of the types of foods that are eaten along with how much is eaten and what they are paired with.
Foods that are high in nutritional value are important to eat during pregnancy for all women.
This is also true for women diagnosed with gestational diabetes. A balanced diet that consists of whole fruits and vegetables, lean proteins, healthy fats, and whole grains should be adhered to.
Limiting foods that contain processed sugar, juices, and baked goods are also important when managing gestational diabetes.
Carbohydrates Should be Limited
Carbohydrates need to be limited and only half the calories consumed in a day should come from this food group.
Processed sweets and soft drinks are very high in sugar while offering little nutritional value.
These types of foods should be avoided, however, other types of carbohydrates like whole grain bread, pasta, and cereals contain fiber which is important during pregnancy.
Six servings of carbohydrates should be eaten each day. One serving would be one slice of bread, one ounce of cereal, or a half a cup of rice or pasta.
These carbohydrates should be consumed in their whole-grain form so that they contain vitamins, minerals, and fibers.
Foods high in starch are usually high in carbohydrates and can raise blood sugar.
These types of foods should be limited and only eaten in small amounts. Some examples of these starchy foods include white potatoes, white rice, white pasta, and white bread.
Carbohydrates are abundant in foods not usually associated with being overly sugary. It is important to remember that while certain foods alone may not be high in carbohydrates, an added ingredient may be.
These include things like sauces, salad dressings, ketchup, any type of fast food, and highly processed foods.
Carbohydrates should be eaten with high-protein foods whenever possible. This is because the protein helps to keep blood sugars lower than when carbohydrates are eaten alone. A good example of this would be eating a piece of whole-grain toast with a hard-boiled egg.
Vegetables Should be Eaten Abundantly
The gestational diabetes diet should contain three to five servings of vegetables per day.
One serving of vegetables is equivalent to one cup of leafy vegetables, ¾ of a cup of vegetable juice, or ½ a cup of cooked or chopped vegetables.
Cooked vegetables can be fresh or frozen, but added sauces, fats, or salts should be avoided. Good vegetable choices include spinach, broccoli, carrots, and peppers.
Fruits Should not be Avoided
Between two to four servings of fruits should be eaten daily. One serving of fruit equals one whole fruit, like a banana, orange, or apple.
It also is equivalent to ½ a cup of chopped, cooked, frozen, or canned fruit. Whole fruits contain more fiber than juices and should be eaten rather than drank.
Canned fruits should be in their own juices rather than syrup to avoid added sugar.
Dairy Products Provide Excellent Nutrition
Four servings of milk and dairy products should be consumed each day. Dairy products are an excellent source of protein and calcium which are important for pregnant women.
One serving in this food group is equal to one cup of milk or yogurt and one and one-half ounces of cheese.
Low fat or skim milk and yogurt are the healthiest options and yogurt should not contain added sugar or sweeteners.
Proteins are Crucial When Managing Gestational Diabetes
Proteins should be consumed in two to three servings per day. One serving of protein includes two to three ounces of beef, poultry, fish, or pork, ½ cup of cooked beans, one egg, or two tablespoons of peanut butter.
Foods rich in protein are also good sources of iron, zinc, and vitamin B. Lean cuts of meat are best and poultry should be hairless to avoid additional fats. Frying should also be avoided to reduce added fats.
Saturated Fats and Processed Sugars Should be Avoided
Fats should be limited, but should not be cut out of the diet entirely. Fats contain much-needed energy which is important for the baby’s growth and brain development.
Healthy oils, like olive, safflower, peanut, and canola are good choices. Foods containing these healthy fats include avocados, olives, and nuts.
Processed sugars and sweets should be avoided as much as possible for those with gestational diabetes.
Sugar-free sweets are a good option for women who experience cravings for sweet foods.
Portion sizes of desserts and other sweets when consumed should be smaller than usual for pregnant women with gestational diabetes.
Eating a well-balanced diet and incorporating moderate low impact exercise into a daily routine goes a long way in managing gestational diabetes.
Diabetic Voice has a sample menu plan published on their website that is very helpful for planning real-life meals while pregnant with gestational diabetes.
Unfortunately, for some women, these things are not enough to keep blood sugar levels low and medications may need to be utilized in addition to dietary changes.
This is why it is so important for women to monitor their blood sugars at specific times during the day so that they can know if their diet and exercise plan is sufficient.